{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:38:58Z","timestamp":1790419138988,"version":"4.1.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2019,1]]},"abstract":"\n Background\u2003Haemodynamic alterations caused by acute pulmonary embolism (PE) may affect multi-organ function including kidneys. This multi-centre, multinational cohort study aimed to validate the prognostic significance of estimated glomerular filtration rate (eGFR) and its potential additive value to the current PE risk assessment algorithms.<\/jats:p>\n Methods\u2003The post hoc analysis of pooled prospective cohort studies: 2,845 consecutive patients (1,424 M\/1,421\u2009F, 66\u2009\u00b1\u200917 years) with confirmed acute PE and followed up for 180 days. We tested prognostic value of pre-specified eGFR level \u226460 mL\/min\/1.73 m2 calculated on admission according to the Modification of Diet in Renal Disease study equation. The primary outcome was all-cause 30-day mortality; the secondary outcomes were PE-related mortality, 180-day all-cause mortality, bleeding and composite outcome (PE-related death, thrombolysis or embolectomy).<\/jats:p>\n Results\u2003Two hundred and twenty-three patients (8%; 95% confidence interval [CI]: 7\u20139%) died within the first 30 days after the diagnosis. The eGFR on admission was significantly lower in non-survivors than in survivors (64\u2009\u00b1\u200934 vs. 75\u2009\u00b1\u20093 mL\/min\/1.73 m2, p\u2009<\u20090.0001). Independent predictors for a fatal outcome included: cancer, systolic blood pressure, older age, hypoxia, eGFR, heart rate and coronary artery disease. The eGFR of \u226460 mL\/min\/1.73 m2 independently predicted all-cause mortality (hazard ratio: 2.3; 95% CI: 1.7\u20133.0, p\u2009<\u20090.0001), PE-related outcome and clinically relevant bleedings (odds ratio: 0.90 per 10 mL\/min\/1.73 m2, 95% CI: 0.85\u20130.95, p\u2009=\u20090.0002). The eGFR assessment significantly improved prognostic models proposed by European guidelines with net re-classification improvement of 0.42 (p\u2009<\u20090.0001).<\/jats:p>\n Conclusion\u2003The eGFR of \u226460 mL\/min\/1.73 m2 not only independently predicted higher 30- and 180-day all-cause mortality and bleeding events, but when added to the current European Society of Cardiology risk stratification algorithm improved identification of both low- and high-risk patients. Therefore, eGFR calculation should be implemented in the risk assessment of acute PE.<\/jats:p>","DOI":"10.1055\/s-0038-1676522","type":"journal-article","created":{"date-parts":[[2018,12,31]],"date-time":"2018-12-31T18:31:15Z","timestamp":1546281075000},"page":"140-148","source":"Crossref","is-referenced-by-count":35,"title":["The Prognostic Value of Renal Function in Acute Pulmonary Embolism\u2014A Multi-Centre Cohort Study"],"prefix":"10.1055","volume":"119","author":[{"given":"Maciej","family":"Kostrubiec","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine & Cardiology, Medical University of Warsaw, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"P\u0142ywaczewska","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine & Cardiology, Medical University of Warsaw, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Respiratory Department and Medicine Department, Ram\u00f3n y Cajal Hospital, IRYCIS and Alcal\u00e1 de Henares University, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mareike","family":"Lankeit","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology and Pneumology, Heart Center, University Medical Center G\u00f6ttingen, Germany"},{"name":"Department of Internal Medicine and Cardiology, Campus Virchow Klinikum (CVK), Charit\u00e9 \u2013 University Medicine Berlin, Berlin, Germany"},{"name":"Center for Thrombosis and Hemostasis, Johannes Gutenberg University of Mainz, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142","family":"Ciurzynski","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine & Cardiology, Medical University of Warsaw, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavros","family":"Konstantinides","sequence":"additional","affiliation":[{"name":"Center for Thrombosis and Hemostasis, Johannes Gutenberg University of Mainz, Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Pruszczyk","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine & Cardiology, Medical University of Warsaw, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2018,12,31]]},"container-title":["Thrombosis and Haemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0038-1676522.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T17:13:32Z","timestamp":1557162812000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0038-1676522"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,31]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2018,12,31]]},"published-print":{"date-parts":[[2019,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0038-1676522","relation":{},"ISSN":["0340-6245","2567-689X"],"issn-type":[{"value":"0340-6245","type":"print"},{"value":"2567-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,31]]}}}